Fewer Medicare Patients Admitted To Hospitals, According To Study

A calculator, pills and a stethoscope on top of a patient form
A new study suggests that federal government pressure has led to an increasing number of Medicare patients being held for observation instead of being admitted to hospitals, according to HealthDay.

The problem? Money…and less access to necessary care.

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According to the researchers from Brown University in Providence, RI, while admitting seniors as inpatients may reduce Medicate costs, patients held for observation are classified as outpatients and, under Medicare rules, may face higher co-payments for in-hospital services and won’t be covered for subsequent care in skilled nursing facilities.

“The dual trends of increasing hospital observation services and declining inpatient admissionssuggest that hospitals and physicians may be substituting observation services for inpatient admissions — perhaps to avoid unfavorable Medicare audits targeting hospital admissions,” the study’s first author, Zhanlian Feng, assistant professor of health services, policy and practice at Brown, said in a university news release.

Observation stays rose from less than 815,000 (2.3 per 1,000 beneficiaries) in 2007 to more than 1 million (2.9 per 1,000 beneficiaries) in 2009. Inpatient admissions fell from 23.9 per 1,000 in 2007 to 22.5 per 1,000 in 2009, the investigators noted.

In addition, the number of patients held for observation longer than 72 hours increased from less than 24,000 in 2007 to nearly 45,000 in 2009, according to the study published in the June issue of the journal Health Affairs.

The practice has angered patient advocacy groups, one of which launched a class-action lawsuit against the federal government last year.